Heroin Withdrawal: Symptoms, Timelines & Treatment

Ideally, a person undergoing heroin withdrawal will seek professional addiction treatment. With medical detox, they can be administered medication to control their symptoms and improve their chances of successfully overcoming their addiction.

Without medical detox, relapse is much more likely as the person may simply return to heroin use to make the discomfort of withdrawal disappear. 

Symptoms of Heroin Withdrawal

Opioid withdrawal, including heroin withdrawal, is often described as having “flu-like” symptoms. Heroin withdrawal is also associated with the following:

• Insomnia and other sleep problems
• Muscle pain
• Bone pain
• Diarrhea
• Vomiting
• Goosebumps
• Cold flashes
• Uncontrollable leg movements

A person going through opioid withdrawal will also experience an intense craving for opioids, generally specifically the drug they’re trying to quit. This, combined with the significant discomfort withdrawal can cause, can make resisting the urge to further use drugs difficult without expert assistance.

Heroin Withdrawal Timeline

Heroin is a short-acting opioid. A person can expect withdrawal symptoms to begin about 8 to 24 hours since their last use of the drug, depending on how much they last used and how dependent their body has grown. 

Heroin withdrawal will last about 4 to 10 days in total. After that, the patient will also experience up to several months of a general feeling of reduced well-being and strong cravings for opioids.

The following is a table to help illustrate the timeline a person can expect when trying to stop use of heroin:

Phase	Length of Time	Symptoms
Initial cessation of heroin use	8–24 hours	Slow building of withdrawal symptoms
Withdrawal	4–10 days	Withdrawal symptoms peaking and then slowly declining in strength
Follow-up care	Up to 6 months	General feeling of being unwell and cravings for opioids
Recovery	Often lifelong	Regained sense of well-being but occasional strong cravings for opioids

The longer a person goes without taking opioids, the lower their tolerance for the drug becomes. If they had previously used the drug heavily and built a strong tolerance, it can be very dangerous for them to go back to their previous level of drug use if they relapse. 

Once tolerance has dropped, a smaller amount of the same drug can have the same effect on the body that a larger dose did in the past. A previously “normal” dose may now cause a person to overdose.

It is best to work to resist drug abuse and seek expert addiction treatment. But if you do relapse after going through withdrawal, monitor your drug use and use a smaller amount of opioids than you had been using before you began the recovery process. 

Can a Person Die From Heroin Withdrawal?

While potentially extremely uncomfortable, heroin withdrawal is not generally dangerous. However, it can cause miscarriage or premature delivery in pregnant individuals. It is generally recommended to undergo methadone maintenance treatment rather than attempt to detox if pregnant. 

It is possible for a person to become dangerously dehydrated while going through heroin withdrawal, which could be dangerous or even deadly in rare cases. Patients undergoing heroin withdrawal should drink 2 to 3 liters of water each day to replace fluids that are lost through sweating and diarrhea. They may also benefit from taking vitamin B and vitamin C supplements.

Ideally, a person will undergo heroin withdrawal at an addiction treatment facility, where experts are aware of the risks of heroin withdrawal and can help control a person’s symptoms. The goal is often to make patients as comfortable as possible during withdrawal. 

If someone is undergoing heroin withdrawal at home or in an otherwise non-medical location, it is important they have someone caring for them who takes hydration seriously.

Heroin Withdrawal Treatment

Treatment for heroin withdrawal will depend on the severity of a person’s symptoms and the extent of their heroin use.

Mild withdrawal treatment generally focuses on symptoms. Doctors will work to keep a person hydrated and to replace important vitamins. More severe withdrawal uses a similar approach, but it may also use medications to further treat symptoms. 

In some cases, drugs may be used to wean the patient off heroin. This can be completed by using drugs with a similar mechanism of action that can be administered in a controlled, medical setting. Many of these medications can largely eliminate withdrawal symptoms, helping to prevent relapse in early recovery.

Medications That Can Help With Heroin Withdrawal

A few different types of medications can help with heroin withdrawal.

Clonidine

This is a type of drug called an alpha-2 adrenergic agonist. It can relieve a wide variety of withdrawal symptoms, dramatically improving patient comfort. 

It is frequently combined with other withdrawal treatments (such as keeping a person hydrated) as they undergo withdrawal. 

Buprenorphine

This drug is considered the best medication for moderate to severe withdrawal management, sharply reducing withdrawal symptoms and cravings. It is a type of medication called a partial opiate agonist, so it significantly reduces cravings for heroin and other opioids. 

Methadone

Methadone is a synthetic, long-acting opioid. With carefully controlled administration, doctors can use it to help wean patients off less controlled, illicit opioid use. One helpful aspect of methadone treatment is that, in being an opioid, it can help reduce a person’s cravings and withdrawal symptoms. At the same time, methadone has a higher potential for abuse than buprenorphine.

Codeine Phosphate

This drug is similar to methadone in that it is an opioid that can be administered in a controlled setting to help a person stop uncontrolled opioid use. As an opioid, it can help reduce a person’s withdrawal symptoms and cravings. 

Codeine can help many people control their symptoms, but it has no effect for about 2 to 10 percent of users. 

Heroin Withdrawal Is the First Step

While withdrawal is a key part of recovery, it isn’t enough on its own. The bulk of recovery work takes place in therapy. Whether you opt for medical detox or a different approach, you aren’t recovered just because heroin is processed out of the body.

You must work to address the underlying issues that led you to heroin. Once those problems get the focus they deserve, you can find a firm footing in recovery.